Plastic surgery denial letter....Who writes the appeal letter?

I just recieved my first denial letter from the insurance (bluecross/blueshieled..cont. airlines) My dr. wrote the first letter with the "infamous" photos, so my question is this....Should he write the appeal letter or should I? I have lost apprx. 160 pounds and the back of my legs/thighs are horrible. This is not cosmetic for me and I've check around and found that this procedure usually runs around 10,000...Help!

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